Difficulty: Medium
Average Score: 78%
Simulated
Passage / Scenario
The nurse is caring for a client in the first stage of laborÔÇó Nurses' Notes
1800: A 31-year-old primigravida at 38 gestational weeks 100% effaced and 2 cm dilated. Contractions occur every 15 minutes lasting for 20 seconds. The client reports that the contractions are becoming more painful and alternate between cramping and pressure.
1825: Informed consent was obtained by the physician for a planned epidural catheter with the administration of analgesia. Signature was witnessed by the RN. Continuous external fetal monitoring was applied. Normal variability was noted with the fetal heart rate of 110-130/minute.
ÔÇó Vital Signs
Temperature 98.0┬░ F (37┬░ C)
Pulse 91/minute
Respirations 16/minute
Blood Pressure 138/76 mm Hg
Oxygen saturation 95% on room air
Drag (1) one condition and (1) assessment to fill in each blank of the following sentence,Immediately following the placement of the epidural, the client is at the highest risk for----------------------and the nurse anticipates a prescription for-------------------------------.
Correct answer
A,B
Rationale
The most common adverse maternal effect associated with epidural analgesia is the development of maternal hypotension. This effect can be mitigated by infusing 0.9% saline bolus pre-procedurally.
Alternatively, lactated ringers may be used instead of 0.9% saline.
Infection may occur with an epidural, but this would not be seen immediately following its placement. Antibiotics are not routinely given before the initiation of epidural analgesia.
This type of analgesia would not cause early fetal decelerations or maternal hyperglycemia.
Alternatively, lactated ringers may be used instead of 0.9% saline.
Infection may occur with an epidural, but this would not be seen immediately following its placement. Antibiotics are not routinely given before the initiation of epidural analgesia.
This type of analgesia would not cause early fetal decelerations or maternal hyperglycemia.